Starling Oncology, Inc.

The Oncology Institute, Inc. (NASDAQ: TOI) operates as a national leader in value-based oncology care delivery, providing medical and radiation oncology services across community-based clinic settings. The company's website is www.theoncologyinstitute.com.

Founded in 2007, TOI evolved from a collection of community oncology practices in Southern California into a multi-state healthcare provider managing approximately 2.0 million patients under value-based agreements as of December 31, 2025. The company operates through a hybrid model combining affiliated physician-owned clinics with independent provider networks. As of year-end 2025, TOI maintained 65 clinics owned by affiliated physicians staffed with 116 providers, 81 independently-owned clinics contracted through its managed services organization, and a network of 198 independent providers across 17 markets spanning five states: California, Arizona, Nevada, Florida, and Oregon.

TOI's business comprises four primary segments: fee-for-service patient care, value-based contracts, specialty pharmacy operations, and clinical trials and research services. In 2025, value-based contracts generated more than 46 percent of patient services revenue. The company's value-based arrangements include capitated contracts, gain-sharing agreements, and full delegation models where TOI assumes responsibility for utilization management, network construction, and claims adjudication alongside care delivery.

The company's differentiation centers on its High Value Cancer Care program, which emphasizes evidence-based treatment protocols aligned with National Comprehensive Cancer Network guidelines while reducing unnecessary costs and improving patient outcomes. TOI provides integrated services including medical oncology, radiation oncology, specialty infusion, oral pharmacy, clinical trials, and palliative care, primarily serving Medicare Advantage, Medicaid, and commercial insurance populations.

TOI maintains contractual relationships with major payors including Anthem, CareMore Health, Heritage Provider Network, and Optum Care. The company's largest customer represented approximately 14 percent of patient services revenue in 2025, indicating limited customer concentration risk. TOI competes with traditional oncology practices, health system-affiliated providers, and specialty benefit managers, distinguishing itself through its vertically integrated approach to aligning physician and payor incentives around quality outcomes and cost efficiency in community-based settings.